Study: Blacks Less Likely to Get Potentially Curative Lung Surgery

By Katherine Hobson

Attention is deservedly paid to new therapies that might add months or years to the lives of cancer patients. But as drug discovery inches along, it’s easy to forget there’s plenty of progress to be made in survival rates simply by making sure that everyone gets the accepted standard of care.

One such area may be surgery for stage I or II non-small cell lung cancer. A study published in JAMA finds that only 55% of black patients eligible for the surgery had it, compared to 66% of white patients. The decision is an important one, since people who don’t have surgery have a median survival of less than a year, while those who do have a median survival of more than 4 years.

To be sure, the new stats show that patients of all races didn’t have surgery, and the study attempted to tease out some of the reasons why. It found that patients having negative perceptions of communication with their doctor, a belief that the diagnosis wasn’t completely certain and a feeling that quality of life would be worse in a year were less likely to get the operation. For black patients, though, there were additional factors associated with a lower chance of surgery — two or more additional illnesses or a lack of a regular source of medical care. (That’s not the same as insurance; more than 90% of those studied were covered.)

There may be an unconscious bias among non-black physicians against providing more aggressive treatment to blacks, the study notes, citing previous research.

While bias and primary-care access are systemic problems, improving communication about the disease, possible treatments and prognosis represents “low-hanging fruit,” Walter Scott, chief of thoracic surgery at Fox Chase Cancer Center, tells the Health Blog. (He wasn’t involved with the study.) “You can improve on those kinds of [communication] skills that are taught in med school and reinforce them in residency.” And, he says, it’s important to help docs learn to communicate effectively with people from all cultural backgrounds.

The study suggests that since physicians are increasingly time-strapped, designated cancer educators — or “supernavigators” — might be used to provide additional information and context to patients.